Tackling Cancer in Sub-Saharan Africa with Pfizer

Photo by Matheus Ferrero on Unsplash

Pfizer recently launched a new initiative to improve access to 11 cancer treatment medications, including chemotherapies, in six African countries that together account for 44 percent of sub-Saharan Africa’s cancer burden. We spoke with Eileen Cheigh, Vice President of the Portfolio Growth Team at Pfizer Essential Health, Parmjot Bains, Senior Director, Global Access Programs, and Darren Back, Senior Director of Social Investments and Global Health Programs at Pfizer to learn more about the new initiative.

We have shared 4 key insights here and you can read the full conversation below.

“This is a new initiative, but it’s not a new approach for Pfizer. We have a history of developing and implementing innovative public-private partnerships to address global health issues.”

— Eileen Cheigh

Four Key Insights from Our Conversation with Pfizer

1. Compare your company’s unique strengths to the social need to identify where a shared philanthropic approach is most effective. We look at global public health needs and identify where, as company, we can address this need through the allocation of resources, whether these are medicines or other resources.
2. Building a new market, whether for a product or a system of treatment, has the potential for great impact but is a significant undertaking. It will take some time to build the market… but we all want to see that happen.
3. Strong partnerships are critical to this work. The fact that the partnership was already established made it easier for us to identify our specific strengths, providing medicines and growing access through product registration, and enter the collaboration in full force.
4. An openness to all perspectives and partners with a shared vision are very helpful for initiatives hoping to tackle a large social challenge. A broad set of partners who share common goals and the willingness and openness to engage with industry as part of the solution are the main factors that made this initiative successful.

What was the impetus for this new initiative? What inspired the focus on oncology? To what extent does this feel like a different way of working for Pfizer?

Darren Back: We’re always looking at the most pressing unmet needs and then overlay that with how we as a company can make a difference. There’s a lot that plays into that — our ability to provide drugs in the country, the capacity of the healthcare delivery system, and an appetite from the Ministry of Health. We look across these factors and then make a decision as a company about the focus of the resources we can apply, whether that’s medicines or other resources. There’s a huge unmet need for cancer care in sub-Saharan Africa and we have a broad range of cancer medicines in our portfolio.

Parmjot Bains: We’ve been looking at the global burden of disease and cancer is emerging as a major problem, particularly in sub-Saharan Africa, for a variety of reasons. Late diagnosis, limited access to treatment, and proliferation of counterfeit drugs are significant challenges. Patients are almost twice as likely to die of cancer in sub-Saharan Africa as in the United States. For example, the five-year survival rate for breast cancer in the U.S. is 90 percent. But in Uganda, it is just 46 percent. And in this region, cancer kills more people than malaria or tuberculosis. These facts make cancer care a clear area of focus for Pfizer.

Eileen Cheigh: This is a new initiative, but it’s not a new approach for Pfizer. We have a history of developing and implementing innovative public-private partnerships to address global health issues. This has built from work that we’ve done in other areas, like family planning, where we have similar partnerships.

Tackling cancer in sub-Saharan Africa is a daunting prospect. How did you get started? What did you have to think about differently with cancer than with family planning?

PB: When we started looking at this area, we found that the American Cancer Society (ACS) and the Clinton Health Access Initiative (CHAI) had already started bringing together a set of partners to address multiple areas of the health ecosystem to improve cancer care in Africa.

EC: The fact that the partnership was already established made it easier for us to leverage our specific strengths, providing medicines and growing access through product registration. We were able to enter the collaboration in full force by bringing 11 cancer therapies into the agreement that are on the World Health Organization’s Essential Medicines List and make up the key regimens for some of the most common cancers in Africa including breast, cervical, colorectal and Kaposi sarcoma.

How does the program actually work?

PB: The program is all about establishing sustainable, high-quality cancer care infrastructure in these countries. ACS and CHAI build capacity and infrastructure within the countries by rolling-out treatment protocols and developing partnerships to build healthcare worker capacity. CHAI also coordinates across hospitals and with ministries of health to identify demand for products. Once they understand what the demand is, the ministry of health or individual hospitals will start the tendering process or place orders. We will offer for sale the 11 Pfizer cancer treatments for those Government tenders and procurement mechanisms. Our hope is to help build a sustainable healthcare structure and to improve health outcomes for patients.

What have been some of the most significant challenges?

PB: So far, the procurement volumes are small and we are working with a number of organizations to implement the program. There will be lots of little challenges along the way and we need to be creative.

EC: One of the things this initiative is focusing on is ensuring quality medications in the supply chain. CHAI is working with governments to ensure alignment with procurement practices to improve patient access to affordable, quality-approved oncology medicine. Budgets and resources can be quite tight for governments and hospitals, and this can result in them choosing the lowest priced product, rather than a product approved by a stringent regulatory authority like the U.S. Food and Drug Administration or the European Medicines Agency.

What is your vision for success with this initiative? How will you measure progress?

PB: In the long-term, success for us is a sustainable, long-term market for cancer medicines so that this is no longer run as a separate initiative, but becomes part of business-as-usual in sub-Saharan Africa.

This work requires a cross-functional team within Pfizer. How have you brought that team together?

PB: The initiative is coordinated by our team in the Essential Health business unit. We led the discussions with global partners and we brought in our colleagues from a variety of areas, such as regulatory, legal, medical, and supply chain. But most of the actual implementation is done by our teams in the countries. We have a regional point person based in Nairobi who coordinates this work across sub-Saharan Africa. He works with our country colleagues, the ministries of health, CHAI, and local hospitals to identify demand and then manage the tender process.

How difficult was it to make the case for this work internally at Pfizer?

EC: This program was not a hard sell internally. It was a clear opportunity for us to make a significant public health impact and leverages our unique offerings in terms of medicines and presence in sub-Saharan African countries. We’re not donating drugs — our intent is to create sustainable markets for these cancer therapies.

PB: The program has support from senior leadership and we’ve also had a lot of engagement and commitment from across the business. Internally, it’s been a great project — everyone can see the potential for impact around the world in public health.

How have your conversations with Ministries gone? How do they think about cancer in addition to the other health issues that they are working to address?

PB: We have seen a large groundswell of interest within sub-Saharan Africa about the need to treat cancer. There are a number of initiatives emerging in cancer care in this area of the world.

What factors have made this partnership successful?

PB: There’s been 3 factors. One, recognition of the enormous unmet need in African countries and demand for quality medicines. Two, a broad set of partners that share a common set of goals and can address this issue in a comprehensive way. Each partner is able to leverage their specific strengths so together we have a stronger impact. And three, willingness and openness from our partners to engage with industry as part of the solution. This is particularly important as we have a lot of different processes and we operate in a highly-regulated industry.

EC: It has taken some time to establish our respective roles but we really started with a willingness and openness to collaborate.

DB: I want to add also that the success of the program has to be credited to this team within Pfizer.

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